CMS Price Transparency Data

Orthotic fitting and training

Facility: Hill Country Memorial Hospital

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97760
Insurance Median: $53
Cash Discount Price: $356
vs. Medicare Baseline: 1.15x Medicare

The contracted insurance negotiated median rate for a Orthotic fitting and training at Hill Country Memorial Hospital is $53. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $356. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 1.15x the Medicare baseline. Located in 1020 South State Highway 16, Fredericksburg, TX.

Cash / Self-Pay

$356

Average discount available for prompt cash payment at this facility.

Insurance Median

$53

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$46.09

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $46.09 (100%)

Cash / Self-Pay: $356 (772%)

Insurance Median: $53 (115%)

Cash: $356 (772% of Medicare)

Ins. Median: $53 (115% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $46.09 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Superior Health	$14 - $47	30%
Community First Health Plans	$32 - $119	69%
Wellmed	$37 - $42	80%
Blue Cross Blue Shield	$39 - $156	85%
Gonzaba Medical Group	$39 - $45	85%
Ilumed	$39 - $45	85%
Triwest	$39 - $45	85%
Aetna	$40 - $220	87%
United	$40 - $198	87%
Wellcare	$40 - $46	87%
Triwest Health Alliance	$45	98%
Molina Healthcare	$62 - $71	135%
Superior	$63 - $72	137%
Healthsmart Preferred Care	$149 - $242	323%
Multiplan	$203 - $375	440%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $356.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 97760.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Hill Country Memorial Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 97760.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.